Steven Soreff, MD. & John Potter. How Alternative was Alternative Medicine? A Comparison of Homeopathic and Allopathic Treatment of Melancholia in Late Nineteenth Century America. Presented at the History of Psychiatry Group. Sixty-Eighth Annual Meeting of the American Association for the History of Medicine, Pittsburgh, Pennsylvania. May, 1995.
Summary
In this paper, we explore the 19th century homeopathic approach to treating mental illness, how it differed from the orthodox treatment of the time, and whether homeopaths were justified in claiming that their methods were dramatically different and more successful than that of their orthodox competitors. We do so, through a case study of a patient suffering from Melancholia who was admitted to the Middletown State Homeopathic Hospital in 1874. Our work focuses on Melancholia, because of the distinctive, unique, and enduring features of this diagnosis. Since Hippocrates first coined the term in 400 BC, the essential feature of Melancholia has been recognized as, in the words of the DSM IV, a “loss of interest or pleasure in all, or almost all, activities or a lack of reactivity to usually pleasurable stimuli.” Moreover, both orthodox physicians and homeopaths, in the nineteenth century, identified this diagnosis in similar terms, thus allowing a comparison of treatment.
In general, homeopathic treatment of the insane consisted of a blend of the conventional and the radical. Concepts of materia medica, the law of the infinitesimal, and the idea of “vital force” were integral parts of the homeopathic medical landscape, and these would become the pillars of the homeopathic approach to mental illness. Homeopathic psychiatrists, mirroring their approach to physical illness, developed specific medications for very specific mental symptoms. Yet, homeopathic psychiatry had other dimensions. In particular, it blended its unique pharmacological perspective with many elements of the “moral treatment” that had been popularized during the first half of the nineteenth century. Like orthodox medicine, homeopathic therapy stressed rest, diet, a moral atmosphere, and abstinence from alcohol and caffeine.
All of these elements came into play in the case study we present. The homeopathic physician selected the medication based on the specific physical and mental complaints of the patient. He shared, however, his orthodox colleagues’ preoccupation with the proper functioning of the patient’s gastrointestinal system, as well as with providing the patient with a calming environment.
In practice, homeopathic psychiatry differed from conventional treatment principally in the choice of medications used. Like their orthodox colleagues, homeopaths identified discrete illnesses that they attempted to treat, but relied mainly on providing a calming and structured atmosphere for the patient. Advocates of homeopathic treatment, though, did bring a renewed moral fervor to the cause of curing insanity during the last decades of the nineteenth century. They claimed that homeopathy offered lower costs, more humane treatment and a greater success rate than conventional treatment. Accordingly, they disparaged the doubts as to the treatability of mental illness that were becoming manifest among their orthodox colleagues, in the 1870s and 80s, as reflecting merely an ignorance of proper technique. Ironically, by the beginning of the 20th century, the homeopaths were also beginning to share the doubts that they had disparaged in their competitors twenty years earlier.